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Switched from APAP to BIPAP
RE: Switched from APAP to BIPAP
Restless leg syndrome doesn't seem to be an issue for me. 

The large number of them, while I was awake, was most definitely a result of me walking around and tossing and turning. Plus, there seemed to be no arousals from PLMs throughout the night, just like in my other sleep study. 

I still do think my issues are rooted in sleep though, just based on what my symptoms are and what times they are most severe.

Are there any sleep disorders besides SDB I should ask my doctor about? None were mentioned during the technologist's report which makes me believe none were observed.
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RE: Switched from APAP to BIPAP
There are multiple sleep disorders but your data doesn't show any signs of most of them. No apnea, no reras, no arousals, no movement issues, sleep stages seem reasonable. The main issue appears to be insomnia and lack of sleep rather than problems during sleep.

That is why I was curious about restless legs being a potential issue making it difficult for you to sleep.
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RE: Switched from APAP to BIPAP
With no Apnea recorded, this might be why PAP can't treat you.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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RE: Switched from APAP to BIPAP
I can guarantee that insomnia isn’t the issue. I rarely / don’t have insomnia.

I am not aware of any arousals and even if I do wake up, I will go back to sleep within 5-10 minutes.

I’m still sleeping for 9+ hours and feel overly tired. Even now I just had 9 hours of sleep and 7 hours after waking up, I could easily take a nap if I were to sit / lie down somewhere.

I promise you I get more than enough sleep.

Besides that, why does my TV fluctuate like that if breathing isn’t an issue and I’m not conscious of it?
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RE: Switched from APAP to BIPAP
I was going off your most recent data, your three examples posted were only 6-7 hours of sleep and were all occurring at strange times (starting at 5-6 AM). Based on the data available that is the most abnormal thing about your sleep.

The fluctuating TV is a curiosity but your most recent examples do show this occurring in more of a rem sleep pattern so it could be that your rem breathing is more irregular than most (rem breathing is usually irregular due to partial paralysis that occurs). The only way we will ever learn more about that breathing is with PSG data during a titration study but neither of your studies so far indicated any breathing issues.

There are plenty of reasons a person can feel tired or fatigued that are not related to sleep issues. I don't question that you feel that way, I just don't see how sleep disordered breathing can be the cause when all the data says otherwise.
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RE: Switched from APAP to BIPAP
I just don’t see what other issue can cause that for a 20 year old male. It’s not just a matter of being tired and fatigued but sleepy as well. 

I have always woken up (within the past couple of years), regardless of how long I’ve slept, feeling like I’ve been hit by a truck.

The hourly to sometimes minutely episodes of what I can only deduce is microsleep, is still something that affects me every single day. 

Overall my symptoms include:
Tired and sleepy
Very Brain fogged 
Microsleep
Feeling unrested upon waking up.



A lot of doctors who don’t even take the time to figure anything out slap on the label of depression. But after talking to multiple people about my feelings and symptoms, they are extremely hesitant to diagnose depression due to my continual effort to fixing my health issue, as well as my somewhat positive attitude whilst in a very unfortunate situation (besides having a health issue)

Besides depression, what else could this be? 

Sleep Apnea / UARS is not the only thing I’ve considered, but has been the thing I always return to due to its exact matching to my symptoms.
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RE: Switched from APAP to BIPAP
(03-16-2022, 11:03 PM)AmirKas Wrote: Besides depression, what else could this be? 

I don't know if this has been mentioned already,

Quote:Sleep disorders are conditions that disturb your normal sleep patterns. There are more than 80 different sleep disorders. Some major types include:
  • Insomnia - being unable to fall asleep and stay asleep. This is the most common sleep disorder.
  • Sleep apnea - a breathing disorder in which you stop breathing for 10 seconds or more during sleep
  • Restless leg syndrome (RLS) - a tingling or prickly sensation in your legs, along with a powerful urge to move them
  • Hypersomnia - being unable to stay awake during the day. This includes narcolepsy, which causes extreme daytime sleepiness.
  • Circadian rhythm disorders - problems with the sleep-wake cycle. They make you unable to sleep and wake at the right times.
  • Parasomnia - acting in unusual ways while falling asleep, sleeping, or waking from sleep, such as walking, talking, or eating

Source: https://medlineplus.gov/sleepdisorders.html

Also, many NIH links further down the page.
Jeff8356

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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RE: Switched from APAP to BIPAP
Depression/anxiety is a possibility
Chronic fatigue syndrome, this is a real issue and it often gets triggered by periods of high stress
Autoimmune diseases can cause chronic fatigue and some can take years to diagnose and similarly many get triggered by stress
Some post infection/chronic infections can can cause things like chronic fatigue (Epstein Barr as an example)
Gut issues (celiac, sibo, IBS etc)

These are just some of the examples I have looked into for my own similar issues. I am only 34 and have been trying to figure out my issue for years now. The one main difference being that my original sleep study and titration study both indicated a sleep issue with 54 and 37 arousals/hr respectively (compared to your 2). Since they are spontaneous arousals doctors don't know what causes them or what to do to try and treat them other than randomly trying different sleep aids, many/most of them being off label antidepressants.

If your issue is a sleep issue then PSG is the only thing that will find it at this point. PSG isn't perfect because many people sleep differently in the strange location and because sleep varies night to night. Unfortunately PSG process is time consuming and expensive so repeat tests are rarely done and now with 2 already done for yourself and both indicating no sleep issues it will be even more difficult to ever prove a sleep issue and the question will be if it is even the cause of symptoms if it only occurs on occasion and not every night.

Again the only thing sleep wise I see being an issue is what does appear to be a lack of sleep at least at times and a screwed up sleep pattern which can cause issues because it messes up your hormones (like melatonin) and neurotransmitters etc which then also affect physical and mental function. People that work shift work often suffer with shift work disorder which matches many of your complaints and the findings so far.

"The disorder is characterized by insomnia symptoms when the person tries to sleep and excessive sleepiness when they are awake. "

https://www.sleepfoundation.org/shift-work-disorder/what-shift-work
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RE: Switched from APAP to BIPAP
Hey Amirkas,

Any updates on your situation? I'm a 22M with such an identical profile it's insane (coincidentally, I also go to the same school as you in the same major..). I just seemingly a bit earlier in my apnea / UARS journey than you. I also have nasal congestion at night, mine almost certainly from enlarged turbinates from allergies (though I haven't gone through a reduction surgery). I've been tweaking my Autoset right now, and am considering getting a BiPAP instead. 

I also have relatively low numbers (AHI 1.6 RDI 8.8 when using my Resmed 10 Autoset 7-10 EPR 3 from a Watchpat one test) yet severe symptoms. And I've also had many people tell me that my brain fog and cognitive symptoms aren't related to sleep disordered breathing. But I'm fairly confident that isn't true, as my symptom severity correlates well with how congested my nose is the previous day. Plus, I've done an almost exhaustive search on other possibilities to no avail - blood tests for deficiencies, brain MRI and CT scan, neuro-psych evaluation, etc. I've been suffering for the past 3 years, ever since I moved into a new apartment that I was severely allergic to. Even though I've moved out, my symptoms haven't improved. 

Any news would be appreciated; our profiles are so similar that I'm fairly confident that if either of us finds a solution, it will also cure the other person's symptoms as well.
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